SPECIALIZED THERAPIES SERVICES PROVIDER IN INDIANA

ENHANCING FUNCTIONAL ABILITY, RECOVERY, AND INDEPENDENCE THROUGH TARGETED THERAPEUTIC INTERVENTIONS

Specialized Therapies in Indiana offer habilitative, rehabilitative, and restorative services to individuals with developmental disabilities, brain injuries, physical impairments, or chronic conditions. These therapies are authorized under Indiana Medicaid Home and Community-Based Services (HCBS) Waiver programs and the Medicaid State Plan, helping individuals achieve greater independence, skill development, and improved quality of life.

1. GOVERNING AGENCIES

Agency: Indiana Family and Social Services Administration (FSSA) — Office of Medicaid Policy and Planning (OMPP) and Division of Disability and Rehabilitative Services (DDRS)

Role: Administers Medicaid waiver funding, oversees provider enrollment, and monitors service delivery quality for Specialized Therapies

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring that Medicaid-funded Specialized Therapy Services meet HCBS standards, person-centered planning requirements, and medical necessity rules

2. SPECIALIZED THERAPIES SERVICE OVERVIEW

Specialized Therapies involve professional, therapeutic interventions tailored to address an individual's unique physical, cognitive, or behavioral needs, supporting optimal functional outcomes.

Approved providers may deliver:

• Physical therapy (PT): Improving mobility, balance, strength, and physical independence

• Occupational therapy (OT): Enhancing self-care, adaptive skills, and environmental interaction

• Speech-language pathology (SLP): Addressing communication disorders, cognitive-communication impairments, and swallowing (dysphagia) challenges

• Behavioral therapies: Supporting individuals with emotional, social, or behavioral challenges through behavior intervention plans and positive behavior supports

• Respiratory therapy (where applicable): Managing chronic respiratory issues and promoting pulmonary health

Therapies must be authorized through the participant’s Individualized Service Plan (ISP) or Plan of Care (POC) based on formal clinical assessments.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business entity with the Indiana Secretary of State

• Obtain EIN from the IRS and NPI (Type 2)

• Enroll as a Medicaid Waiver provider through the Indiana Medicaid Provider Enrollment Portal

• Hold active Indiana licensure for each therapy discipline (PT, OT, SLP, Behavioral Therapist as applicable)

• Maintain general liability and professional malpractice insurance

• Develop policies covering therapy assessment, service delivery, documentation, participant protections, and HIPAA compliance

• Ensure all clinical staff meet licensure, background checks, and continuing education requirements

4. INDIANA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit Provider Enrollment Application through the Indiana Medicaid Provider Portal for Specialized Therapies under the appropriate waiver programs

Application and Documentation Submission:

• Submit Articles of Incorporation, EIN/NPI verification, professional licensure documents, insurance certificates, staff credentialing and training documentation, and operational therapy service policies

Program Readiness Review:

• FSSA (DDRS or Aging Division) reviews provider readiness, including therapy service planning, participant-centered documentation practices, staff supervision structures, and billing compliance systems

Approval & Medicaid Enrollment:

• Upon approval, providers are assigned billing codes for therapy evaluations, re-evaluations, treatment sessions, and participant training activities

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Indiana Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Active Indiana Professional Licenses (PT, OT, SLP, Behavioral Therapist)

• Proof of general liability and professional malpractice insurance

• Specialized Therapies Services Policy & Procedure Manual including:

  • Participant intake, therapy evaluation, service authorization, and plan of care development

  • Direct therapy delivery, caregiver training, and participant progress tracking

  • Emergency preparedness, critical incident reporting, and participant safety procedures

  • Participant rights, HIPAA confidentiality, and grievance resolution procedures

  • Staff credentialing, licensure tracking, supervision logs, and annual competency assessments

  • Medicaid billing, documentation tracking, and audit readiness protocols

6. STAFFING REQUIREMENTS

Role: Clinical Supervisor / Therapy Program Director

Requirements: Licensed PT, OT, SLP, Psychologist, or Behavior Analyst; clinical supervision experience preferred; background screening clearance

Role: Licensed Therapists (PTs, OTs, SLPs, Behavior Analysts)

Requirements: Active Indiana license in respective therapy discipline; background clearance; annual continuing education required

Role: Therapy Assistants (where allowed)

Requirements: Licensed Physical Therapist Assistants (PTAs) or Certified Occupational Therapy Assistants (COTAs); background clearance; must work under licensed therapist supervision

All staff must complete:

• Person-centered planning training and HCBS Settings Rule training

• Abuse prevention, HIPAA compliance, and confidentiality training

• Infection control and emergency response training

• Annual professional development and skills competency evaluations

7. MEDICAID WAIVER PROGRAMS

Specialized Therapies are reimbursed through:

• Community Integration and Habilitation (CIH) Waiver

• Family Supports Waiver (FSW)

• Aged and Disabled (A&D) Waiver

• Traumatic Brain Injury (TBI) Waiver

• Medicaid State Plan services for medically necessary therapy interventions

Approved providers may deliver:

• Initial therapy evaluations and re-evaluations

• Ongoing direct therapy sessions (PT, OT, SLP, Behavioral)

• Adaptive skill training and caregiver education

• Transition support following hospital discharge or major life events

8. TIMELINE TO LAUNCH

Phase: Business Formation and Professional Licensing Compliance Preparation

Timeline: 1–2 months

Phase: Staff Hiring, Credentialing, and Therapy Program Development

Timeline: 2–3 months

Phase: Indiana Medicaid Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing System Setup and Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

Indiana Family and Social Services Administration (FSSA) — Division of Disability and Rehabilitative Services (DDRS)

Website: https://www.in.gov/fssa/ddrs/

Indiana Office of Medicaid Policy and Planning (OMPP)

Website: https://www.in.gov/fssa/ompp/

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov/

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — INDIANA SPECIALIZED THERAPIES PROVIDER

WCG assists therapy practices, rehabilitation agencies, and behavioral health providers in launching Medicaid-compliant Specialized Therapy Services across Indiana.

Scope of Work:

• Business registration, Medicaid enrollment, and professional licensing guidance

• Development of Specialized Therapies Services Policy & Procedure Manual

• Staff credentialing templates, therapy intake forms, treatment plan templates, and progress tracking systems

• Medicaid billing system setup and audit-ready claims management

• Website, domain, and professional branding setup

• Clinical compliance systems including incident reporting, quality audits, and participant rights protections

• Strategic partnership development with case managers, hospitals, outpatient providers, and community-based organizations

Continue To Our Client Portal To Get Started

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.